Effectiveness of NVX-CoV2373 and BNT162b2 COVID-19 Vaccination in South Korean Adolescents
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Purpose
Adolescents can have severe/chronic outcomes from COVID-19. Real-word data on relative vaccine effectiveness (rVE) between mRNA- and protein-based vaccines are limited, and more data are needed on disease outcomes in this age group.
Methods
The K-COV-N database, COVID-19 vaccine registry, and health insurance claims were retrospectively reviewed to identify adolescents (12–18-year-olds) in South Korea who received a homologous primary series of NVX-CoV2373 or BNT162b2 and a heterologous or homologous third vaccine dose. Vaccine recipients were propensity score matched to reduce confounding baseline factors. Adjusted hazard ratios (aHRs) for any medically attended COVID- 19 post vaccination (starting 14 days post primary series and 7 days post third dose) were calculated to assess rVE every 30 days through a 180-day risk window.
Results
From February to December 2022, 3174 and 6253 doses of NVX-CoV2373 and BNT162b2, respectively, were administered to South Korean adolescents. Individuals who received NVX-CoV2373 tended to be older, have a disability, and/or have a prior SARS-CoV-2 infection. Propensity score matching resulted in 107 individuals in each primary series group and 701 and 1417 individuals in the NVX-CoV2373 and BNT162b2 third-dose groups, respectively. The aHR (95% CI) for NVX-CoV2373 compared with BNT162b2 for medically attended COVID-19 in the 180-day risk window was 0.57 (0.31–1.05) for the primary series and 0.68 (0.54–0.84) for the third dose.
Discussion
These results suggest that NVX-CoV2373 may provide more robust protection against medically attended COVID-19, compared to BNT162b2, both as a homologous primary series and as a homologous or heterologous third dose.
Implications and Contributions
This study provides essential data on the real-world effectiveness of a protein-based (NVX- CoV2373) and an mRNA-based (BNT162b2) COVID-19 vaccine in adolescents. A homologous primary series and homologous/heterologous third dose of NVX-CoV2373 provided more robust protection than BNT162b2 at preventing medically attended COVID-19, with protection demonstrated through 6 months post vaccination.
